Joint Arthroplasty: Current Status, Challenges, and Future Directions

Dear Colleagues,

Total joint arthroplasty procedures are among the most prevalent and utilized surgeries in modern medicine, improving pain and function for millions of patients annually. Improvements in surgical technique, implant design and materials, intra-operative enabling technologies, and perioperative management have all contributed to the resounding success of total joint arthroplasty. Furthermore, an ever-increasing body of research has helped clinicians better optimize and indicate patients for these procedures, thereby improving their rates of success.

Despite monumental strides in the fields of joint arthroplasty over the past 40‒50 years, there are still many unsolved problems. Populations undergoing total joint arthroplasty are increasingly comorbid, thus highlighting the importance of preoperative optimization and evidence-based recovery pathways. Periprosthetic joint infection continues to be a leading cause of failure, with significant associated morbidity, mortality, and cost. With the wide adoption of cementless hip implants and an aging population, periprosthetic fracture remains a clinical challenge that is increasing in prevalence. Finally, patients expect higher levels of post-operative function. This has sparked interest in alternative concepts of lower extremity alignment about the knee, spinopelvic mechanics in the hip, and the rapid development of new implants and technologies to enable these concepts.

Research regarding patient selection and optimization, mitigation and treatment of major complications, and optimizing function and recovery is still necessary. By understanding the current state of the art and challenges in joint arthroplasty, future options may offer safer, higher-functioning joint replacements for patients.

Dr. Alexander B. Christ
Guest Editor

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